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HLTC23H3 (86)
R Song (30)
Lecture 7


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University of Toronto Scarborough
Health Studies
R Song

Nutrition, Growth and Long-Term Consequences  Ecological reality of poverty o Have to look at spheres of influence o Spatial levels o Beyond childhood, over time  help strategize for life and shit o Unique life history  What strategies used for growth and development, reproductive events, etc.  Inevitable trade-offs that occur in growth and reproduction Requirements for Life  Macronutrients o Larger amounts needed, critical for providing energy (calories/joules)  Carbs, fats, protein  Micronutrients o Smaller amounts required, critical for regulating biological functions  Vitamins, minerals, water  Malnutrition o Not enough/too much of either macro or micro o Problem of distribution, but also production, since there is variability in the ability to produce and distribute food o Measure of ecological failure  Reflects population‘s inability to adapt to its environment o Consequences:  Weight loss, slowing/cessation of growth  Immune system impairment, morbidity, cognitive/psych/behavioural impairment  Reduced fecundity (potential kids) and fertility (realized kids) in women  Increased labout time/risks to mother and infant  Infant mortality, reduced work capacity, efficiency, acitivity  Adult diseases (heart, diabetes, metabolic, etc.)  Increased/early mortality o GROWTH FALTERING IS NOT ONLY PRODUCT OF ENERGY DEFICIENCY; also: protein, zinc, calcium, sulfur, iron o Repeated infections  reduce apetite and absorption of nutrients in gutmore malnourished  Infections+malnourishment=deadly, ‗cause even if you get enough supplementation, you can‘t absorb it  Some infections INCREASE REQUIREMENTS FOR DIETARY ENERGY  To compensate/cope for their body growth, etc. o malnutritionimpaired immunocompetence, reduced resistance to infectioninfectious disease o Exposure to infectious disease in generalanorexia/appetite losee, malabsorption, elevated BMR due to feer and protein catabolism malnutrition  (vicious cycle) –synergistic relationship to exacerbate original condition (infection-nutrition complex)  Association between moderate to severe malnutrition and history of prior episodes on infection  Diarrhea  Worsens nutritional status  Mucosal damage and depressed immunity  Downward spiral  Ex. more commonly gastrointestinal infections  Immunocompetence and Growth Faltering o Exposure to infection  immune response o PEM affects immunocompetence: B lymphocyte development and response to antigenic challenge  Three Types of Malnutrition: o Energy (calories) / PEM –most severe  quality o Protein  quantity o Micronutrient (―marginal‖)—least severe  Protein and Calorie Malnutrition o Deficiency in energy content of food, and/or deficiency in protein o Can range from total starvation o Generally food staples, rice, corn, potatoes  protein deficient foods, cheaper  Less meats and etc.  Protein Calorie Deficiency o MARASMUS: muscle depletion of kwashiorkor with a loss of most body fat; slowing/cessation of growth; characteristic ―wizened‖ (old) appearance of head; vomiting, diarrhea (dehydration); increased susceptibility to disease (most will die of infectious/diarrheal diseases); lethargy  So protein and calorie deficient that the body has used up all of its fat stores and starts eating away at the muscle for energy  KWASHIORKOR: muscle atrophy, growth failuyre, skin rash, edema –water retention—distended belly  Micronutrient deficiency o Associated with low birth weight and poor infant neurobehavioural development at birth  Dietary quality  Vit. A-D, etc.  Ca, Zn, I, Fe, etc.  Ex. rickets—deficiency in vit. D
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